The GFF’s Catalytic Role
The GFF Catalytic Role provides details on the GFF support for Indonesia’s Reproductive, Maternal, Neonatal, Child, and Adolescent Health and Nutrition (RMNCAH-N) agenda. Details on past and ongoing work are provided along with plans for future support. The GFF Catalytic Role focuses on support provided in the areas of the Investment Case (IC), Health Financing and systems reforms, the country platform, partner alignment, and data use for decision-making.
- Developing a costed and prioritized investment case: The GFF supports the development and implementation of the National Strategy to Accelerate Stunting Prevention (StraNas Stunting), which serves as the investment case (IC) for Indonesia. Within the IC the GFF supports the convergence of high impact interventions across sectors. In addition, it supports the scaleup of (a) early childhood development (ECD) services for parents and children under two; (b) nutrition sensitive food assistance; and (c) behavior change communication (BCC) efforts. It also supports the strengthening of governance and accountability systems, including establishment of a data-driven monitoring and evaluation system for the IC to strengthen management capacity for implementation.
- Prioritizing and implementing health financing and systems reforms: The GFF contributed to the scaling up of a village convergence scorecard and mobilization of health development workers (HDWs) to empower 70,000+ villages to converge services and leverage village budget for stunting reduction. Moreover, the GFF supports the rollout of innovative technology solutions (for example, the e-HDW mobile application) to enable real-time monitoring from 75,000 villages and improve HDW capacity to manage the convergence program at village level. In addition, the GFF helps improve the performance assessment of fiscal transfers to districts and villages to enhance accountability for results. The GFF also backs introduction of a new financing instrument to incentivize coordination and implementation of the convergence program. Furthermore, the GFF supports development of a system for tracking government expenditures on priority nutrition interventions and institutionalizing a comprehensive nutrition budget review to link spending with performance.
- Strengthening the country platform and convening financial and technical partners at country level: At the national level, the GFF has helped to strengthen the leadership and oversight capacity of the Office of Vice President to secure political commitment at all levels. At the district level, GFF has supported districts to implement the convergence action plan and enhance alignment of planning and budgeting process with the priorities outlined in StraNas Stunting.
- Improving data for decision making: The GFF supports establishment of a results monitoring team in the Office of the Vice President to address bottlenecks; use of monitoring dashboard as data visualization tool at central and district levels; institutionalization of district performance assessment for planning and budgeting; and peer-to-peer learning and best practice sharing across districts.
Core RMNCAH-N Impact Indicators
The 8 GFF core impact indicators reflect updates aligned with the in-country survey schedule which optimally occurs once every three to five years to determine population-based changes in important health and nutrition outcomes. These indicators are core to the GFF Logic Model, to reflect impact of aligned interventions over time. Collected by governments and development partners, these indicators are also used to monitor the Every Woman Every Child Initiative and the 2030 Sustainable Development Goals (SDGs) for RMNCAH-N. The country survey data includes Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS), which are funded by domestic resources as well as by the World Health Organization (WHO), UNICEF, USAID and other multi- and bilateral organizations. The Covid-19 pandemic forced several countries to cancel or re-schedule plans for survey data collection these past two years.
The GFF highlights progress between the two most recent point estimates from population-based surveys approved by countries. The timing of the data points is dependent on when survey data are available, which introduces lags. In addition, it has been demonstrated that stillbirths tend to be under-reported in population based surveys1. For many of the indicators highlighted in this table, annual estimates are produced through global processes. The globally produced estimates can be found through the following sites:
Core Health Financing Indicators
The six GFF core health financing indicators track changes to country budget and expenditures with a focus on health spending, to monitor the expected impact of increasing the total volume and value of funding allocated to health and nutrition. The GFF partnership supports financing reforms by engaging with ministries of finance and ministries of health to strengthen mobilization of domestic resources as well as allocative and technical efficiency. These indicators are tracked through country-specific data sources such as BOOST, NHA, and budget reports. Expenditure data are tracked through the Global Health Expenditure Database (GHED), for which data are available through the end of 2018. Through measurement of budgets and expenditures, the GFF partnership aims to accelerate the expansion of interventions that are high-impact, cost-effective, affordable, and feasible to accelerate progress on universal health coverage and in achieving SDG targets.
Survey and Estimated RMNCAH-N Coverage
The RMNCAH-N coverage data includes a standard set of 9 RMNCAH-N coverage indicators from available population-based surveys from 2010 to the most recent available survey. These indicators show progress towards key goals across maternal, child, and adolescent health and nutrition outcomes. Additional key nutrition-specific and/or education-specific coverage indicators are presented for countries where the GFF co-finances a nutrition-focused World Bank project or where education is a strong focus of the IC.
The RMNCAH-N coverage data are sourced from the most recent available population-based surveys. Data on immunization are presented from the WHO/UNICEF joint reporting process and recent population-based surveys.
Resource mapping is a key component of the GFF approach. The resource mapping exercise helps countries assess funding gaps, align donor and government resources, and improve the efficiency and equity of health spending. Resource mapping data for each country varies based on whether countries have completed one or more resource mapping exercises.
Since Indonesia’s investment case is focused on nutrition, the country’s resource mapping covers multiple sectors. Indonesia’s National Planning Agency and Ministry of Finance are leading a budget tagging exercise that enables multisectoral resource mapping for domestic resources. With support from the World Bank and GFF, the government launched financing reforms for institutionalizing multisectoral expenditure tracking system, which is prepared on an annual basis and linked to a robust performance review and course correction process. The multisectoral nutrition budget tagging, tracking, and evaluation is included in the disbursement-linked indicators in the GFF cofinanced project (INEY PforR). Results for budget tagging and tracking were completed in 2019 and 2020. The nutrition budget performance reviews in 2019 and 2020 were widely disseminated to key national stakeholders and have been used to improve the prioritization of the interventions, strengthen program implementation, and guide resource allocation by identifying service delivery gaps.
Monitoring The Country-led Process
The GFF Logic Model highlights key elements of a GFF co-financed country-led process that contribute to the expected impact of improved RMNCAH-N outcomes over time. The GFF has developed a core set of indicators to monitor implementation of the GFF approach, considered as inputs and activities in the model, that emphasize prioritization and alignment to capitalize on efficiencies to improve transparency and accountability as well as health outcomes. Process monitoring includes tracking investment case development, country stakeholder engagement, health financing and the inclusion of gender and equity approaches.
The data in this section is provided for a selection of indicators from the Investment Case Results Framework, Health Financing priorities, and the World Bank Project as applicable. Please select indicators from the dropdown menu to view the data for each indicator. Where subnational data is available, the map will display subnational trends over time or the latest data available. Hovering over the map will display additional data for the select indicator. Clicking on a region will add it to the chart on the right. All data, including source information, may be downloaded by selecting the arrow to the right of the indicator dropdown menu.